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脑电双频指数及其与接受地氟烷或七氟醚麻醉的脊柱矫正手术患者苏醒试验期间意识的关系。

Bispectral index and their relation with consciousness of the patients who receive desflurane or sevoflurane anesthesia during wake-up test for spinal surgery for correction.

机构信息

Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea.

出版信息

Korean J Anesthesiol. 2012 Jan;62(1):13-8. doi: 10.4097/kjae.2012.62.1.13. Epub 2012 Jan 25.

Abstract

BACKGROUND

Wake-up tests may be necessary during surgery for kypho-scoliosis to ensure that spinal function remains intact. It is difficult to predict the time when patients can respond to a verbal command. We evaluated the effectiveness of the bispectral index (BIS) and its relation to patients' levels of consciousness in wake-up tests during desflurane and sevoflurane anesthesia.

METHODS

Eighteen patients each were enrolled in the desflurane and sevoflurane groups for spinal correction surgery. We measured BIS values, blood pressure, heart rate, and consciousness state and time, at the points when patients responded during the wake-up test.

RESULTS

The BIS values when patients made fists upon a verbal command (T3) were 86.7 ± 7.5 for desflurane and 90.3 ± 5.4 for sevoflurane. Patients in the desflurane group had significantly shorter wake up delays than those in the sevoflurane group (6.9 ± 1.8 min vs. 11.8 ± 3.6 min). However, there was no difference between the groups in the time between the response to a verbal command and the time when a patient moved their toes in response to verbal commands. No recall of the wake-up tests occurred in either group.

CONCLUSIONS

The values obtained using the BIS index could to some extent predict the time of a patient's and would be informative during desflurane and sevoflurane anesthesia. Moreover, desflurane permitted faster responses to verbal commands than sevoflurane, and allowed the wake-up test to be performed sooner.

摘要

背景

脊柱后凸侧凸手术中可能需要唤醒试验以确保脊柱功能完整。很难预测患者对口头命令做出反应的时间。我们评估了在七氟醚和地氟醚麻醉中使用脑电双频指数(BIS)监测唤醒试验时患者意识水平的有效性及其与意识水平的关系。

方法

18 名患者分别纳入地氟醚和七氟醚组进行脊柱矫正手术。我们测量了患者在唤醒试验中做出握拳反应时(T3)的 BIS 值、血压、心率和意识状态及时间。

结果

地氟醚组患者握拳时的 BIS 值为 86.7±7.5,七氟醚组为 90.3±5.4。地氟醚组患者的唤醒延迟时间明显短于七氟醚组(6.9±1.8 分钟比 11.8±3.6 分钟)。然而,两组患者从发出口头命令到脚趾对口头命令做出反应的时间无差异。两组患者均未回忆起唤醒试验。

结论

BIS 指数值在一定程度上可以预测患者的时间,并在地氟醚和七氟醚麻醉中提供信息。此外,与七氟醚相比,地氟醚能更快地对口头命令做出反应,并且可以更早地进行唤醒试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/928d/3272522/a5e2fe4f5666/kjae-62-13-g001.jpg

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